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Emergency Department Administration

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https://www.readbyqxmd.com/read/29150146/annual-trends-in-follow-up-visits-for-pediatric-concussion-in-emergency-departments-and-physicians-offices
#1
Liraz Fridman, Michal Scolnik, Alison Macpherson, Linda Rothman, Astrid Guttmann, Anne M Grool, Daniel Rodriguez Duque, Roger L Zemek
OBJECTIVE: To assess whether children and youth with concussion receive follow-up visits in accordance with the recommended guidelines. STUDY DESIGN: We conducted a retrospective, population-based study using linked health administrative data from all concussion-related visits to emergency department and physician offices by children aged 5 through 18 years (range, 5.00-18.99) in Ontario between 2003 and 2013. We analyzed the percentage of children and youth seen for follow-up...
November 14, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/29146489/exploring-the-barriers-to-and-facilitators-of-using-evidence-based-drugs-in-the-secondary-prevention-of-cardiovascular-diseases-findings-from-a-multistakeholder-qualitative-analysis
#2
Victoria Miller, Lavanya Nambiar, Malvika Saxena, Darryl Leong, Amitava Banerjee, José Pablo Werba, Jose Rocha Faria Neto, Katherine Curi Quinto, Mohammed Moniruzzaman, Shweta Khandelwal
BACKGROUND: Health-system barriers and facilitators associated with cardiovascular medication adherence have seldom been studied, particularly in low- and middle-income countries where uptake rates are poorest. OBJECTIVES: This study sought to explore the major obstacles and facilitators to the use of evidence-supported medications for secondary prevention of cardiovascular disease using qualitative analysis in 2 diverse countries across multiple levels of their health care systems...
November 13, 2017: Global Heart
https://www.readbyqxmd.com/read/29145705/review-article-critical-care-airway-management-elearning-modules
#3
REVIEW
Deepak Doshi, Sally McCarthy, Elizabeth Mowatt, Angela Cahill, Bronwyn Peirce, Geoff Hawking, Ruth Osborne, Belinda Hibble, Katharine Ebbs
The Australasian College for Emergency Medicine (ACEM) has recently launched the Critical Care Airway Management eLearning modules to support emergency medicine trainees in developing their airway management skills in the ED. A team of emergency physicians and trainees worked collaboratively to develop the eLearning resources ensuring extensive stakeholder consultation. A comprehensive resource manual was written to provide learners with knowledge that underpins the modules. ACEM provided project coordination as well as administrative and technical team support to the production...
November 16, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29139173/incidence-of-in-hospital-and-post-discharge-diagnosed-hospital-associated-venous-thromboembolism-using-linked-administrative-data
#4
Joanne M Stubbs, Hassan Assareh, Jennifer Curnow, Kerry Hitos, Helen M Achat
BACKGROUND: Hospital-associated venous thromboembolism (HA-VTE) is a serious adverse event, preventable with appropriate care during and post admission. Accurate measurement of in-hospital and post-discharge incidences is essential for implementation and evaluation of prevention strategies and monitoring. AIMS: To estimate in-hospital and post-discharge diagnosed VTEs, trends and risk factors. METHODS: A population-based study in New South Wales, Australia using linked hospital admission and emergency department data for 2010-2013, amongst adult patients with a minimum stay of 48 hours...
November 15, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/29137905/emergency-department-chest-radiography-for-children-with-asthma-exacerbation-is-infrequently-associated-with-change-of-management
#5
Evan H Allie, Henry E Dingle, William N Johnson, Jeffrey R Birnbaum, Melissa A Hilmes, Sudha P Singh, Donald H Arnold
BACKGROUND: Acute asthma exacerbations (AAE) account for many Pediatric Emergency Department (PED) visits. Chest radiography (CXR) is often performed in these patients to identify practice-changing findings such as pneumonia (PNA). Limited knowledge exists to balance the cost and radiation dose of CXR with expected yield of clinically meaningful information. OBJECTIVE: To determine in children with AAE with CXR, whether patient characteristics are associated with radiographic PNA; and significant practice change by initiation of antibiotic...
October 6, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29137902/effects-of-opioid-medications-on-cognitive-skills-among-emergency-department-patients
#6
Catherine A Marco, Dennis Mann, Jordan Rasp, Michael Ballester, Oswald Perkins, Michael B Holbrook, Kyle Rako
INTRODUCTION: Treatment for pain and related conditions has been identified as the most common reason for Emergency Department (ED) visits. Concerns exist regarding the effects of opioid pain medications on cognition and patient ability to consent for procedures, hospital admission, or to refuse recommended medical interventions. This study was undertaken to identify cognitive skills before and after opioid pain medication in the ED setting. METHODS: This was a prospective study comparing performance on the Mini-Mental Status Examination (MMSE) and Montreal Cognitive Assessment (MoCA) before and after administration of opioid pain medications...
November 8, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29137674/the-development-of-the-parents-a-tool-for-parents-to-assess-residents-non-technical-skills-in-pediatric-emergency-departments
#7
Katherine A Moreau, Kaylee Eady, Kenneth Tang, Mona Jabbour, Jason R Frank, Meaghan Campbell, Stanley J Hamstra
BACKGROUND: Parents can assess residents' non-technical skills (NTS) in pediatric emergency departments (EDs). There are no assessment tools, with validity evidence, for parental use in pediatric EDs. The purpose of this study was to develop the Parents' Assessment of Residents Enacting Non-Technical Skills (PARENTS) educational assessment tool and collect three sources of validity evidence (i.e., content, response process, internal structure) for it. METHODS: We established content evidence for the PARENTS through interviews with physician-educators and residents, focus groups with parents, a literature review, and a modified nominal group technique with experts...
November 14, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/29135777/validity-of-using-inpatient-and-outpatient-administrative-codes-to-identify-acute-venous-thromboembolism-the-cvrn-vte-study
#8
Margaret C Fang, Dongjie Fan, Sue Hee Sung, Daniel M Witt, John R Schmelzer, Steven R Steinhubl, Steven H Yale, Alan S Go
BACKGROUND: Administrative data are frequently used to identify venous thromboembolism (VTE) for research and quality reporting. However, the validity of these codes, particularly in outpatients, has not been well-established. OBJECTIVE: To determine how well International Classification of Diseases, Ninth Revision (ICD-9) codes for VTE predict chart-confirmed acute VTE in inpatient and outpatients. PATIENTS AND METHODS: We selected 4642 adults with an incident ICD-9 diagnosis of VTE between years 2004 and 2010 from the Cardiovascular Research Network Venous Thromboembolism cohort study...
December 2017: Medical Care
https://www.readbyqxmd.com/read/29131874/association-between-inhaled-corticosteroid-use-and-bone-fracture-in-children-with-asthma
#9
Natasha Gray, Andrew Howard, Jingqin Zhu, Laura Y Feldman, Teresa To
Importance: Daily use of inhaled corticosteroids is a widely recommended treatment for mild persistent asthma in children. There is concern that, similar to systemic corticosteroids, inhaled corticosteroids may have adverse effects on bone health. Objective: To determine whether there is an increased risk of bone fracture associated with inhaled corticosteroid use in children with asthma. Design, Setting, and Participants: In this population-based nested case-control study, we used health administrative databases to identify a cohort of children aged 2 to 18 years with a physician diagnosis of asthma between April 1, 2003, and March 31, 2014, who were eligible for public drug coverage through the Ontario Drug Benefit Program (Ontario, Canada)...
November 13, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/29126081/multiple-chronic-condition-profiles-and-survival-among-oldest-old-male-patients-with-hip-fracture
#10
Jinmyoung Cho, Eileen M Stock, I-Chia Liao, John E Zeber, Brian K Ahmedani, Rashmita Basu, Charlene C Quinn, Laurel A Copeland
To improve understanding of survival among very elderly male patients with surgically repaired hip fractures, this study applied classification techniques to multiple chronic conditions (MCC) then modeled survival by latent class. Veterans Health Administration (VHA)'s electronic medical records on male inpatients age 85-100 years (n=896) with hip fracture diagnosis and repair were used. MCC defined by Charlson and Elixhauser disorders, medications, demographic covariates, and 5 years follow-up survival were included...
October 28, 2017: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/29124464/linezolid-associated-hypoglycemia
#11
Herman Joseph Johannesmeyer, Suhani Bhakta, Felix Morales
Our case describes a 77-year-old, African American male who was experiencing recurrent hypoglycemic episodes, which resulted in two emergency department (ED) visits and a subsequent inpatient admission during his second ED visit. He was prescribed linezolid 600 mg twice daily for 14 days for the treatment of a Staphylococcus hominis urinary tract infection. Nine and a half days into therapy, the patient began having recurrent hypoglycemic episodes. These episodes persisted despite repeated intravenous dextrose boluses...
November 9, 2017: Drug Safety—Case Reports
https://www.readbyqxmd.com/read/29122973/capsaicin-cream-for-treatment-of-cannabinoid-hyperemesis-syndrome-in-adolescents-a-case-series
#12
Jessica Graham, Michael Barberio, George Sam Wang
Cannabinoid hyperemesis syndrome (CHS) is an underrecognized diagnosis among adolescents. In the adult literature, it is characterized as nausea, vomiting, and abdominal pain in patients with chronic marijuana use. CHS is often refractory to the standard treatment of nausea and vomiting. Unconventional antiemetics, such as haloperidol, have been successful in alleviating symptoms; however, even 1 dose of haloperidol can lead to grave adverse effects, such as dystonia, extrapyramidal reactions, and neuroleptic malignant syndrome...
November 9, 2017: Pediatrics
https://www.readbyqxmd.com/read/29121806/the-medical-care-of-male-and-female-youth-who-die-by-suicide-a-population-based-case-control-study
#13
Anne E Rhodes, Michael H Boyle, Jeffrey A Bridge, Mark Sinyor, Laurence Y Katz, Kathryn Bennett, Amanda S Newton, Paul S Links, Lil Tonmyr, Robin Skinner, Amy Cheung, Jennifer Bethell, Corine Carlisle
OBJECTIVE: Prior year medical care was compared among youth dying by suicide to their peers. Effect modification of these associations by age or place of residency (rural versus larger community sizes) was examined in a large, medically insured population. METHOD: This population-based case control study used data from the Office of the Chief Coroner in Ontario, Canada, linked to health care administrative data to examine associations between medical care for mental health or other reasons (versus no medical care) and suicide...
January 1, 2017: Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie
https://www.readbyqxmd.com/read/29117959/barriers-and-facilitators-to-provide-quality-tia-care-in-the-veterans-healthcare-administration
#14
Teresa M Damush, Edward J Miech, Jason J Sico, Michael S Phipps, Greg Arling, Jared Ferguson, Charles Austin, Laura Myers, Fitsum Baye, Cherie Luckhurst, Ava B Keating, Eileen Moran, Dawn M Bravata
OBJECTIVE: To identify key barriers and facilitators to the delivery of guideline-based care of patients with TIA in the national Veterans Health Administration (VHA). METHODS: We conducted a cross-sectional, observational study of 70 audiotaped interviews of multidisciplinary clinical staff involved in TIA care at 14 VHA hospitals. We de-identified and analyzed all transcribed interviews. We identified emergent themes and patterns of barriers to providing TIA care and of facilitators applied to overcome these barriers...
November 8, 2017: Neurology
https://www.readbyqxmd.com/read/29116997/hospital-differences-drive-antibiotic-delays-for-black-patients-compared-with-white-patients-with-suspected-septic-shock
#15
Stephanie Parks Taylor, Colleen H Karvetski, Megan A Templin, Brice T Taylor
OBJECTIVE: Evaluate racial disparities in sepsis processes of care. DESIGN: Observational cohort study. SETTING: Nine hospitals in the Southeastern United States between 2014 and 2016. PATIENTS: Two thousand two hundred twenty-one white and 707 black patients treated in the emergency department through "code sepsis" pathway for suspected septic shock. MEASUREMENTS AND MAIN RESULTS: Black patients were less likely to receive timely antibiotics than were white patients using multiple definitions (1 hr from code sepsis activation [odds ratio, 0...
November 7, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29113549/the-final-30-days-of-life-a-study-of-patients-with-gastrointestinal-cancer-in-ontario-canada
#16
Shaila J Merchant, Katherine Lajkosz, Susan B Brogly, Christopher M Booth, Sulaiman Nanji, Sunil V Patel, Nancy N Baxter
BACKGROUND: Studies have reported overly aggressive end-of-life care (EOLC) in many cancers. We investigate trends in, and factors associated with, aggressive EOLC among patients who died of gastrointestinal (GI) cancers in Ontario, Canada. METHODS: All patients with primary cause of death from esophageal, gastric, colon, and anorectal cancer from January 2003 to December 2013 were identified through the Ontario Cancer Registry, and information was collected from linked databases...
January 1, 2017: Journal of Palliative Care
https://www.readbyqxmd.com/read/29110979/complications-from-administration-of-vasopressors-through-peripheral-venous-catheters-an-observational-study
#17
Kamal Medlej, Amin Antoine Kazzi, Ahel El Hajj Chehade, Mothana Saad Eldine, Ali Chami, Rana Bachir, Dina Zebian, Gilbert Abou Dagher
BACKGROUND: The placement of a central venous catheter for the administration of vasopressors is still recommended and required by many institutions because of concern about complications associated with peripheral administration of vasopressors. OBJECTIVE: Our aim was to determine the incidence of complications from the administration of vasopressors through peripheral venous catheters (PVC) in patients with circulatory shock, and to identify the factors associated with these complications...
October 27, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29108736/a-randomized-double-blind-trial-comparing-the-effect-on-pain-of-an-oral-sucrose-solution-vs-placebo-in-children-1-to-3%C3%A2-months-old-undergoing-simple-venipuncture
#18
Serge Gouin, Nathalie Gaucher, Denis Lebel, Marie Pier Desjardins
BACKGROUND: Few clinical trials evaluating the efficacy of oral sweet solutions for procedures in the emergency department (ED) have been published. OBJECTIVES: To compare the efficacy of an oral sucrose solution vs. a placebo in reducing pain in infants undergoing venipuncture without cannulation. METHODS: A randomized, double-blinded clinical trial was conducted in a pediatric ED. Infants 1 to 3 months old were randomly allocated to receive 2 mL of 88% sucrose or 2 mL of placebo, 2 min prior to venipuncture...
November 3, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29108660/usefulness-of-electroencephalography-for-the-management-of-epilepsy-in-emergency-departments
#19
A Viloria Alebesque, A López Bravo, E Bellosta Diago, S Santos Lasaosa, J A Mauri Llerda
INTRODUCTION: Electroencephalography (EEG) is an essential diagnostic tool in epilepsy. Its use in emergency departments (ED) is usually restricted to the diagnosis and management of non-convulsive status epilepticus (NCSE). However, EDs may also benefit from EEG in the context of other situations in epilepsy. METHODS: We conducted a retrospective observational study using the clinical histories of patients treated at our hospital's ED for epileptic seizures and suspicion of NCSE and undergoing EEG studies in 2015 and 2016...
November 3, 2017: Neurología: Publicación Oficial de la Sociedad Española de Neurología
https://www.readbyqxmd.com/read/29108437/latent-profiles-of-early-developmental-vulnerabilities-in-a-new-south-wales-child-population-at-age-5%C3%A2-years
#20
Melissa J Green, Stacy Tzoumakis, Kristin R Laurens, Kimberlie Dean, Maina Kariuki, Felicity Harris, Nicole O'Reilly, Marilyn Chilvers, Sally A Brinkman, Vaughan J Carr
OBJECTIVE: Detecting the early emergence of childhood risk for adult mental disorders may lead to interventions for reducing subsequent burden of these disorders. We set out to determine classes of children who may be at risk for later mental disorder on the basis of early patterns of development in a population cohort, and associated exposures gleaned from linked administrative records obtained within the New South Wales Child Development Study. METHODS: Intergenerational records from government departments of health, education, justice and child protection were linked with the Australian Early Development Census for a state population cohort of 67,353 children approximately 5 years of age...
November 1, 2017: Australian and New Zealand Journal of Psychiatry
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